Arizona Medicaid Program Faces Legal Action Over Autism Therapy Access
In a significant legal development, Arizona’s Medicaid program, AHCCCS, is at the center of a lawsuit that could affect access to essential therapy for approximately 1,000 children with autism. The legal action, initiated by an attorney on behalf of nearly a dozen families, seeks class-action status.
The lawsuit highlights that insurers Mercy Care and Arizona Complete Health have terminated contracts with key treatment providers, Action Behavior Centers and Centria Health. This decision has left numerous families scrambling for alternative therapy options. The core issue involves disagreements over reimbursement rates, but parents emphasize the severe implications: their children’s progress is at risk without steady access to Applied Behavior Analysis (ABA) therapy.
Families involved in the lawsuit argue that AHCCCS policies mandate the continuation of services based on patient need, but these services are capped at 45 days post-identification of the need. Current waitlists for therapy services far exceed this timeframe, further complicating the situation.
While AHCCCS has chosen not to comment on ongoing litigation, the outcome of this lawsuit could have far-reaching implications for Medicaid-covered autism therapy services in Arizona.
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